People ≥50 years of age who are household contacts of a person who is, or is expected to become, immunocompromised are recommended to receive zoster vaccine. This indirectly protects the immunocompromised household member from exposure to varicella-zoster virus (VZV).
Because the efficacy of zoster vaccines is not 100%, the vaccinated household member may still develop herpes zoster from wild-type VZV.
The rate of VZV-like rashes after Zostavax from the vaccine virus is very low. It is unlikely that vaccine-associated virus would be transmitted from a person recently vaccinated with Zostavax to a susceptible immunocompromised contact.1 VZV from vaccine-associated virus is not possible with Shingrix.
If a vaccinated person develops a varicella- or zoster-like rash after Zostavax, they should:
cover the rash
avoid contact with people who are immunocompromised until the rash clears